BSG

Regional Training Directors Manual

This manual was conceived out of a training and development day for Training Programme Directors in Gastroenterology and subsequent discussions at the Royal College of Physicians in London in September 2007. The event was jointly sponsored by the BSG and the JRCPTB and involved the BSG Training Committee and invited speakers. The content of this manual was derived from the contributors and discussion which followed. These are acknowledged in the appendix box 3.The first version was produced in 2008 and it is updated annually.

High resolution esophageal pressure topography (EPT) is an evolutionary technology incorporating the combination of high resolution manometry (HRM) and pressure topography plotting in the form of Clouse plots introduced in 2000 for the clinical evaluation of esophageal motility. Prior to that, EPT had been developed and utilized as a highly innovative research modality. The HRM Working Group first met in San Diego during DDW 2007 with the objective of adapting EPT to the clinical evaluation of esophageal motility. Since then, a series of HRM Working Group meetings have ensued on a more-or-less annual basis to review, critique, and plan the iterative process of developing a practical classification for esophageal motility disorders based on EPT-specific metrics and criteria. The classification scheme was initially branded 'The Chicago Classification' in 2007 following a series of seminal publications defining key EPT metrics and interpretation criteria optimized for clinical EPT studies emanating from a group of investigators at Northwestern University in Chicago. Since then, two iterations of the Chicago Classification have been published summarizing the incremental development of the classification scheme. The most recent meeting of the HRM Working Group was in Ascona, Switzerland in conjunction an international congress focused on the clinical evaluation of esophageal disease. This paper summarizes the Chicago Classification of esophageal motility disorders emanating from the meeting at the Ascona congress.

Duty of Candour – Advice for Gastroenterologists

Being open and honest with patients is something that all practising gastroenterologists in the UK have probably taken for granted throughout their career. However, in 2015 explicit guidance was published by the GMC along with the nursing and midwifery council highlighting the professional duty of candour for doctors (1) and furthermore there are now plans to implement a statutory duty of candour for healthcare providers in all four nations of the UK.

In essence the professional duty of candour can be summarised as: "Every healthcare professional must be open and honest with patients when something that goes wrong with their treatment or care causes, or has the potential to cause, harm or distress. This means that healthcare professionals must:

Tell the patient (or, where appropriate, the patient’s advocate, carer or family) when something has gone wrong.

Apologise to the patient (or, where appropriate, the patient’s advocate, carer or family).

Offer an appropriate remedy or support to put matters right (if possible).

Explain fully to the patient (or, where appropriate, the patient’s advocate, carer or family) the short and long term effects of what has happened."

BSG guidance on the use of faecal calprotectin testing in IBD

Updated guidance document on use of faecal calprotectin – both in assessment of GI symptoms, and also in patients with known IBD.

Dr Barney Hawthorne, Chair BSG IBD Section Committee, October 2016.

Differentiation between inflammatory bowel disease (IBD) and functional gut disorders, and the determination of mucosal disease activity in established cases of IBD remain the cornerstones of disease diagnosis and management. Non-invasive, accurate biomarkers of gut inflammation are needed due to the variability of symptoms, the inaccuracies of currently available blood markers and the cost and invasive nature of endoscopy. Numerous biomarkers have been used and/or considered with some in current use...